Neural Responses to Reward or Loss May Be Altered by Last Migraine Proximity

Pain is a symptom of migraine, which is part of bodily and sensory functions, rather than an isolated event, researchers posit.

The proximity of the last migraine attack during both the
pre-ictal and interictal periods may alter the neural responses to loss
anticipation and reward or loss based consumption, according to a study
published in Scientific Reports.
The researchers also found that secondary reward processing is sensitive to the
different characteristics of migraine state both ictally and interictally.

Researchers recruited patients with episodic migraine (n=29)
and headache-free controls (n=41) to investigate the neural responses during
different stages of reward processing, based on a hypothesis that there are
differences in patients with migraine during reward or loss anticipation and
consumption. Researchers also aimed to investigate the possibility that these
stimuli influence the duration of migraine history, attack frequency, and time
of the last migraine attack before scan session on neural activations.

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Participants with migraine kept a headache diary to document
the time, duration, and intensity of the attacks, as well as any accompanying
symptoms. The study investigators used a monetary incentive delay task to model
reward and punishment anticipation. Participants were told they could gain
money or avoid financial loss if they responded to a target on a computer
screen fast enough. All participants were given a functional magnetic resonance
imaging (MRI) scan with a 3T MRI scanner to measure neural responses during
anticipation, measured by win-neutral outcome, loss-neutral outcome,
success-neutral outcome, and failure-neutral outcome activations.

In patients with episodic migraine, there was decreased
activation in 1 cluster covering the right inferior frontal gyrus pars
opercularis during reward/no loss consumption, when compared with the controls.
There was a significant negative correlation between the time of the last
migraine attack before the scan, and activation of the parahippocampal gyrus
and the right hippocampus yielded to loss anticipation.

This study is limited by the investigators’ inability to
properly measure the impact of high-frequency attacks on reward processing.

To the best of the investigators’ knowledge, this is the
first study examining monetary reward and loss processing in patients with
episodic migraine. These findings illuminate the potential association between
anticipation processes toward aversive events and migraine attacks. More
research is needed to determine whether there is a causal relation between
them. It remains unclear whether interictal functional brain alterations
interact with different pain-related processes.